After 18 years, Arc'Angel ambulance service closes

The county's last private ambulance company will cease operations Friday, forcing the Henderson County Rescue Squad to pick up its non-emergency transports.

By Nathaniel AxtellTimes-News Staff Writer

The county's last private ambulance company will cease operations Friday, forcing the Henderson County Rescue Squad to pick up its non-emergency transports. Arc'Angel Trans-support Services has provided non-emergency medical transports in Henderson County for 18 years, typically taking non-ambulatory patients between nursing homes and doctor's offices or hospitals. Starting Friday, the company will no longer dispatch ambulances from its office on Haywood Road and most of those non-emergency trips will be picked up by the Rescue Squad, according to county officials. Emergency calls will not be affected by the switch.Arc'Angel's owner could not be reached for comment Thursday, although a worker reached at the company's office confirmed they were closing Friday. It appears the business' shuttering came about because of reduced funding for non-emergency transports under the Affordable Care Act.“Unfortunately, that's the biggest impact on them, the fact that the Affordable Care Act has reduced funding available to them,” said Emergency Services Director Rocky Hyder. Hyder said the county realized last year that the Affordable Care Act was going to “change significantly” the funding mechanisms for non-emergency transports by reducing the Medicaid and Medicare dollars reimbursed for ambulance service.Seeing that writing on the wall, the county Board of Commissioners voted last fall to terminate two private ambulance franchisees located outside the county “in an effort to control the adverse effects of the Affordable Care Act on private ambulance service locally,” said Hyder.That left Arc'Angel as the lone private franchisee providing non-emergency transports. With its closing, County Manager Steve Wyatt said “that responsibility falls back onto the county, whether legally or just because it's the right thing to do.”But Wyatt said the county's new responsibility “proved fortuitous” because commissioners, working in partnership with the nonprofit Rescue Squad, “greatly increased the capacity” of the squad to meet its increased call volume.Last year, commissioners gave the Rescue Squad $100,000 to expand shift coverage and lift pay for part-time employees. They also allocated $181,000 for a new four-wheel-drive ambulance, which was financed over four years at $48,113 annually.Rescue Squad Chief Jimmy Brissie said the squad currently runs one ambulance 12 hours a day, but needs to add another shift 24 hours, seven days a week to cover all emergency and non-emergency calls the squad receives. That will require bringing on eight to 10 part-time EMTs. Brissie said he anticipates revenues from running more non-emergency transports will offset the increased payroll. Since January, he said, the squad has run about two non-emergency calls daily on average. That's expected to rise to six per day on average, starting Friday.The major concern now, Wyatt said, is making sure the Rescue Squad has adequate cash flow.“These (non-emergency) trips are reimbursable by Medicaid and Medicare, but they can run slow,” Wyatt said. “The Rescue Squad has a limited amount of cash on hand, but I have assured Chief Brissie that the county will find a way to make the finances work.”That could come in the form of accelerated quarterly payments or fronting the squad monies until the federal government reimburses it, Wyatt said. Either way, he said “if the Rescue Squad gets in a financial pinch, the county has the capability of helping them to smooth those bumps, and we're committed to doing it.”Just because ambulance transports are deemed non-emergency doesn't mean they're not serious, Wyatt said.“This ain't no taxicab service,” he said. “These are our neighbors, our parents and our grandparents that are being served by these ambulances, often with the need for oxygen. It also frees up capacity, because if you have timely service, doctors are able to see more people — they come in, they're treated, and that frees up resources for others.”Reach Axtell at 828-694-7860 or than.axtell@blueridgenow.com.